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COMPLIANCE INFO_2007-2008
Environmental Health - Public
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EHD Program Facility Records by Street Name
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FAIRMONT
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2300 - Underground Storage Tank Program
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PR0231331
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COMPLIANCE INFO_2007-2008
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Last modified
6/20/2023 10:36:46 AM
Creation date
6/3/2020 9:43:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2007-2008
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231331_975 S FAIRMONT_2007-2008.tif
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EHD - Public
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r <br /> SWRCB,January 2002 Page f <br /> 4. TANK ANNULAR TESTING <br /> Test Method Developed By: KTank Manufacturer ❑ Industry Standard Professional Engineer <br /> ❑Other(Specify) <br /> Test Method Used: ❑ Pressure !XVacuum ❑ Hydrostatic <br /> ❑Other(Sped) <br /> Test Equipment Used: 0 t, ,< 4 € Equipment Resolution: —I <br /> Tank# L Tank# Tank# Tank# <br /> Is Tank Exempt From Testing?' ❑ Yes V<N o 1 il ❑Yes ❑NYes ❑ No ' ❑Yes ❑No <br /> Tank Capacity: <br /> Tank Material: <br /> Tank Manufacturer: <br /> Product Stored: p eA b <br /> Wait time between applying <br /> pressure/ acuu ater and <br /> �t <br /> startingtest: <br /> Test Start Time: e)4 ` <br /> Initial Reading(R,): 1� <br /> t f <br /> 1 <br /> Test End Time: ( m G) a <br /> Final Reading(RF): <br /> Test Duration: o v, <br /> Change in Reading(RF-R,): C <br /> i <br /> Pass/Fail Threshold or Criteria: P le <br /> Test Result: Pass D Fail "Pass ❑Fail ❑;Pass ❑ Fail Al Pass ❑ Fail <br /> Was sensor removed for testing? es ❑No ❑NA ❑jYes ❑No El NA ❑ 'es ❑No ❑NA G Yes ❑No ❑`NA <br /> Was sensor properly replaced and Aes ❑No ❑NA 0 Yes ❑No ❑NA 0 Yes ❑No ❑NA ❑Yes ❑No ❑NSA <br /> verified functional after testin ? <br /> Comments—(include information on repairs made prior to testing, and recommended follow-up or failed tests) <br /> ' Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br /> containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment <br /> testing. {Caliturnia Code of Regulations, Title 23, Section 2637(a)(6)) <br />
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